Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
BMC Psychiatry
Published in: BMC Psychiatry 1/2017

Open Access 01-12-2017 | Research article

Affective concordance in couples: a cross-sectional analysis of depression and anxiety consultations within a population of 13,507 couples in primary care

Authors: J. Walker, J. Liddle, K. P. Jordan, P. Campbell

Published in: BMC Psychiatry | Issue 1/2017

Login to get access

Abstract

Background

Depression and anxiety are common and have a significant impact on the individual and wider society. One theory proposed to explain a heightened risk for depression and anxiety is affective concordance in couples (e.g. influence of shared mood states, shared health beliefs). Whilst research has shown concordance for severe psychiatric illnesses and general mood in couples, little attention has been given to concordance for common psychiatric conditions such as depression and anxiety. The aims of this study were to test affective concordance in couples and examine potential influences on concordance.

Methods

Study design is a 1-year cross-sectional study of anxiety and depression consultations in primary care. Data were obtained from a validated primary care database of recorded consultations. Outcome was the presence of an anxiety or depression Read Code (GP recorded reason for consultation) in the female (within the couple dyad), and exposure was a recorded Read Code of anxiety or depression in the male. Logistic regression was used to test associations with odds ratios (OR) and 95% confidence intervals (95% CI) reported. Statistical adjustment was carried out on potential influences of concordance; age, environment (deprivation), healthcare behaviour (consultation frequency), and comorbidity.

Results

A population of 13,507 couples were identified in which 927 people consulted for anxiety and 538 for depression. Logistic regression showed a 3 times increase in odds of an anxiety consultation in females if their male partner had also consulted OR 2.98 (95% CI 2.15 to 4.13). For depression females were over 4 times the odds of consulting if their male partner had also consulted OR 4.45 (95% CI 2.79 to 7.09). Adjustment within a multivariable model showed some reduction in odds; concordant anxiety was reduced to 2.5 times odds OR 2.48 (95%CI 1.76 to 3.50) and depression reduced to OR 3.39 (2.07 to 5.54).

Conclusion

Results show significant associations for affective concordance in couples. Factors influencing concordance are comorbidity and environmental factors, however reasons for deciding to consult (positive or negative) are unknown. This study highlights the patients’ social context as a factor in consultations for anxiety and depression and gives support to the consideration of the patient’s household as an influence on mental health.
Literature
1.
Baxter AJ, Scott KM, Vos T, Whiteford HA. Global prevalence of anxiety disorders: a systematic review and meta-regression. Psychol Med. 2013;43(05):897–910.CrossRefPubMed
2.
Bloom DE, Cafiero E, Jané-Llopis E, Abrahams-Gessel S, Bloom LR, Fathima S, Feigl AB, Gaziano T, Hamandi A, Mowafi M, O’Farrell D. The global economic burden of noncommunicable diseases. Program on the global demography of aging; 2012.
3.
National Audit Office. Mental Health Services: Preparations for improving access. Department of Health and NHS England. Report to House of Commons, 20th April 2016. www.​nao.​org.​uk. Accessed 12 Jan 2017.
4.
Thomeer MB. Multiple chronic conditions, Spouse’s depressive symptoms, and gender within marriage. J Health Soc Behav. 2016;57(1):59–76.CrossRefPubMed
5.
Lieb R, Becker E, Altamura C. The epidemiology of generalized anxiety disorder in Europe. Eur Neuropsychopharmacol. 2005;15(4):445–52.CrossRefPubMed
6.
Strine TW, Mokdad AH, Balluz LS, Gonzalez O, Crider R, Berry JT, Kroenke K. Depression and anxiety in the United States: findings from the 2006 behavioral risk factor surveillance system. Psychiatric Services. 2008;59(12):1383-90.
7.
King M, Semlyen J, Tai SS, Killaspy H, Osborn D, Popelyuk D, Nazareth I. A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people. BMC Psychiatry. 2008;8(1):1.CrossRef
8.
Mitchell AJ, Vaze A, Rao S. Clinical diagnosis of depression in primary care: a meta-analysis. Lancet. 2009;374(9690):609–19.CrossRefPubMed
9.
Davidson SK, Harris MG, Dowrick CF, Wachtler CA, Pirkis J, Gunn JM. Mental health interventions and future major depression among primary care patients with subthreshold depression. J Affect Disord. 2015;177:65–73.CrossRefPubMed
10.
Hölzel BK, Lazar SW, Gard T, Schuman-Olivier Z, Vago DR, Ott U. How does mindfulness meditation work? Proposing mechanisms of action from a conceptual and neural perspective. Perspect Psychol Sci. 2011;6(6):537–59.CrossRefPubMed
11.
Moreno-Peral P, Conejo-Cerón S, Motrico E, Rodríguez-Morejón A, Fernández A, García-Campayo J, Roca M, Serrano-Blanco A, Rubio-Valera M, Bellón JÁ. Risk factors for the onset of panic and generalised anxiety disorders in the general adult population: a systematic review of cohort studies. J Affect Disord. 2014;168:337–48.CrossRefPubMed
12.
Heim C, Binder EB. Current research trends in early life stress and depression: review of human studies on sensitive periods, gene–environment interactions, and epigenetics. Exp Neurol. 2012;233(1):102–11.CrossRefPubMed
13.
Naismith SL, Norrie LM, Mowszowski L, Hickie IB. The neurobiology of depression in later-life: clinical, neuropsychological, neuroimaging and pathophysiological features. Prog Neurobiol. 2012;98(1):99–143.CrossRefPubMed
14.
Craske MG, Waters AM. Panic disorder, phobias, and generalized anxiety disorder. Annu Rev Clin Psychol. 2005;1:197–225.CrossRefPubMed
15.
Meyler D, Stimpson JP, Peek MK. Health concordance within couples: a systematic review. Soc Sci Med. 2007;64(11):2297–310.CrossRefPubMed
16.
Di Castelnuovo A, Quacquaruccio G, Donati MB, De Gaetano G, Iacoviello L. Spousal concordance for major coronary risk factors: a systematic review and meta-analysis. Am J Epidemiol. 2009;169(1):1–8.CrossRefPubMed
17.
Hippisley-Cox J, Coupland C, Pringle M, Crown N, Hammersley V. Married couples’ risk of same disease: cross sectional study. BMJ. 2002;325(7365):636.CrossRefPubMedPubMedCentral
18.
Hemminki K, Dong C, Vaittinen P. Cancer risks to spouses and offspring in the family-cancer database. Genet Epidemiol. 2001;20(2):247–57.CrossRefPubMed
19.
Leong A, Rahme E, Dasgupta K. Spousal diabetes as a diabetes risk factor: a systematic review and meta-analysis. BMC Med. 2014;12(1):1.CrossRef
20.
Campbell P, Shraim M, Jordan KP, Dunn KM. In sickness and in health: a cross-sectional analysis of concordance for musculoskeletal pain in 13,507 couples. Eur J Pain. 2016;20(3):438–46.CrossRefPubMed
21.
Mueller B, Nordt C, Lauber C, Rueesch P, Meyer PC, Roessler W. Social support modifies perceived stigmatization in the first years of mental illness: a longitudinal approach. Soc Sci Med. 2006;62(1):39–49.CrossRefPubMed
22.
Low N, Cui L, Merikangas KR. Spousal concordance for substance use and anxiety disorders. J Psychiatr Res. 2007;41(11):942–51.CrossRefPubMed
23.
Cardol M, van Dijk L, van den Bosch WJ, Spreeuwenberg P, de Bakker DH, Groenewegen PP. Striking variations in consultation rates with general practice reveal family influence. BMC Fam Pract. 2007;8(1):1.CrossRef
24.
Butterworth P, Rodgers B. Concordance in the mental health of spouses: analysis of a large national household panel survey. Psychol Med. 2006;36(05):685–97.CrossRefPubMed
25.
Pachucki MA, Jacques PF, Christakis NA. Social network concordance in food choice among spouses, friends, and siblings. Am J Public Health. 2011;101(11):2170–7.CrossRefPubMedPubMedCentral
26.
Li J, Loerbroks A, Angerer P. Physical activity and risk of cardiovascular disease: what does the new epidemiological evidence show? Curr Opin Cardiol. 2013;28(5):575–83.CrossRefPubMed
27.
Cummings E, Keller PS, Davies PT. Towards a family process model of maternal and paternal depressive symptoms: exploring multiple relations with child and family functioning. J Child Psychol Psychiatry. 2005;46(5):479–89.CrossRefPubMed
28.
Gordon KC, Friedman MA, Miller IW, Gaertner L. Marital attributions as moderators of the marital discord–depression link. J Soc Clin Psychol. 2005;24(6):876–93.CrossRef
29.
Goodman CR, Shippy RA. Is it contagious? Affect similarity among spouses. Aging Ment Health. 2002;6(3):266–74.CrossRefPubMed
30.
Joutsenniemi K, Moustgaard H, Koskinen S, Ripatti S, Martikainen P. Psychiatric comorbidity in couples: a longitudinal study of 202,959 married and cohabiting individuals. Soc Psychiatry Psychiatr Epidemiol. 2011;46(7):623–33.CrossRefPubMed
31.
Robles TF, Slatcher RB, Trombello JM, McGinn MM. Marital quality and health: a meta-analytic review. Psychol Bull. 2014;140(1):140.CrossRefPubMed
32.
Bowling, A. Research Methods in Health. Investigating Health and Health Services. Buckingham: Open University Press; 1997.
33.
Jordan K, Clarke AM, Symmons DP, Fleming D, Porcheret M, Kadam UT, Croft P. Measuring disease prevalence: a comparison of musculoskeletal disease using four general practice consultation databases. Br J Gen Pract. 2007;57(534):7–14.PubMedPubMedCentral
34.
Porcheret M, Hughes R, Evans D, Jordan K, Whitehurst T, Ogden H, Croft P. Data quality of general practice electronic health records: the impact of a program of assessments, feedback, and training. J Am Med Inform Assoc. 2004;11(1):78–86.CrossRefPubMedPubMedCentral
35.
Weiskopf NG, Weng C. Methods and dimensions of electronic health record data quality assessment: enabling reuse for clinical research. J Am Med Inform Assoc. 2013;20(1):144–51.CrossRefPubMedPubMedCentral
36.
Häyrinen K, Saranto K, Nykänen P. Definition, structure, content, use and impacts of electronic health records: a review of the research literature. Int J Med Inform. 2008;77(5):291–304.CrossRefPubMed
37.
NHS Information Authority. The clinical terms version 3 (the read codes). Birmingham: NHS Information Authority; 2000.
38.
McGregor J, Fone D, Dunstan F, Cornish R, Lyons RA, Lloyd KR. Case-finding for common mental disorders of anxiety and depression in primary care: an external validation of routinely collected data. BMC Med Inform Decis Mak. 2016;16(1):35.CrossRefPubMedPubMedCentral
39.
Burton C, Campbell P, Jordan K, Strauss V, Mallen C. The association of anxiety and depression with future dementia diagnosis: a case-control study in primary care. Fam Pract. 2013;30(1):25.CrossRefPubMed
40.
Torgersen S, Kringlen E, Cramer V. The prevalence of personality disorders in a community sample. Arch Gen Psychiatry. 2001;58(6):590–6.CrossRefPubMed
41.
Van Melle JP, De Jonge P, Spijkerman TA, Tijssen JG, Ormel J, Van Veldhuisen DJ, Van Den Brink RH, Van Den Berg MP. Prognostic association of depression following myocardial infarction with mortality and cardiovascular events: a meta-analysis. Psychosom Med. 2004;66(6):814–22.CrossRefPubMed
42.
Bair MJ, Wu J, Damush TM, Sutherland JM, Kroenke K. Association of depression and anxiety alone and in combination with chronic musculoskeletal pain in primary care patients. Psychosom Med. 2008;70(8):890.CrossRefPubMedPubMedCentral
43.
Picavet HS, Schouten JS. Musculoskeletal pain in the Netherlands: prevalences, consequences and risk groups, the DMC 3-study. Pain. 2003;102(1):167–78.CrossRefPubMed
44.
Toft T, Fink P, Oernboel E, Christensen KA, Frostholm L, Olesen F. Mental disorders in primary care: prevalence and co-morbidity among disorders. Results from the functional illness in primary care (FIP) study. Psychol Med. 2005;35(08):1175–84.CrossRefPubMed
45.
Foster A, Jordan K, Croft P. Is frequent attendance in primary care disease-specific? Fam Pract. 2006;23(4):444–52.CrossRefPubMed
46.
47.
Payne RA, Abel GA. UK indices of multiple deprivation-a way to make comparisons across constituent countries easier. Health Stat Q. 2012;1(53):22.
48.
49.
Umberson D. Gender, marital status and the social control of health behavior. Soc Sci Med. 1992;34(8):907–17.CrossRefPubMed
50.
Nilsen SM, Bjørngaard JH, Ernstsen L, Krokstad S, Westin S. Education-based health inequalities in 18,000 Norwegian couples: the Nord-Trøndelag health study (HUNT). BMC Public Health. 2012;12(1):1.CrossRef
51.
52.
Podsakoff PM, MacKenzie SB, Lee JY, Podsakoff NP. Common method biases in behavioral research: a critical review of the literature and recommended remedies. J Appl Psychol. 2003;88(5):879.CrossRefPubMed
53.
Benson T. The history of the read codes: the inaugural James read memorial lecture 2011. J Innov Health Inform. 2011;19(3):173–82.CrossRef
54.
Glasgow RE, Kaplan RM, Ockene JK, Fisher EB, Emmons KM. Patient-reported measures of psychosocial issues and health behavior should be added to electronic health records. Health Aff. 2012;31(3):497–504.CrossRef
55.
56.
Butzlaff RL, Hooley JM. Expressed emotion and psychiatric relapse: a meta-analysis. Arch Gen Psychiatry. 1998;55(6):547–52.CrossRefPubMed
57.
Hooley JM. Expressed emotion and relapse of psychopathology. Annu Rev Clin Psychol. 2007;3:329–52.CrossRefPubMed
58.
Caqueo-Urízar A, Rus-Calafell M, Urzúa A, Escudero J, Gutiérrez-Maldonado J. The role of family therapy in the management of schizophrenia: challenges and solutions. Neuropsychiatr Dis Treat. 2015;11:145.PubMedPubMedCentral
59.
60.
Khan A, Lasker SS, Chowdhury TA. Are spouses of patients with type 2 diabetes at increased risk of developing diabetes? Diabetes Care. 2003;26(3):710–2.CrossRefPubMed
Metadata
Title
Affective concordance in couples: a cross-sectional analysis of depression and anxiety consultations within a population of 13,507 couples in primary care
Authors
J. Walker
J. Liddle
K. P. Jordan
P. Campbell
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2017
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-017-1354-7

Other articles of this Issue 1/2017

BMC Psychiatry 1/2017 Go to the issue

Case report

Case report of anti-N-methyl-D-aspartate receptor encephalitis in a middle-aged woman with a long history of major depressive disorder

Research article

Pain severity predicts depressive symptoms over and above individual illnesses and multimorbidity in older adults

Research article

Retinoids, anxiety and peripartum depressive symptoms among Chinese women: a prospective cohort study

Research article

The comparative effectiveness and efficiency of cognitive behaviour therapy and generic counselling in the treatment of depression: evidence from the 2nd UK National Audit of psychological therapies

Research article

Minor depression in older, long-term unemployed people seeking vocational support

Research article

Assessment of eating disorders with the diabetes eating problems survey – revised (DEPS-R) in a representative sample of insulin-treated diabetic patients: a validation study in Italy